Behavioral and Psychosocial Risk Factors that Lead Individuals to Initiate and/or Maintain Betel Quid Chewing in Developed and Developing Countries: A Systematic Review.

BACKGROUND: Betel quid (BQ) is the fourth most commonly used psychoactive substance and its use is highly prevalent among southeast Asian countries due to the influence of psychosocial, behavioral, and environmental factors. As a result, even young children and women are becoming addicted and find it difficult to achieve long-term abstinence. Systematic research addressing the influence of behavioral and psychosocial factors on BQ chewing is scarce, hence pointing to the need for understanding the interplay of these factors to develop tailored intervention strategies for BQ cessation. OBJECTIVE: The objective of this systematic review is to assess various behavioral and psychosocial risk factors from pre-existing literature that lead individuals to initiate and/or maintain BQ chewing in developed and developing countries. MATERIALS AND METHODS: The electronic retrieval systems and databases PUBMED [MEDLINE], EMBASE, SCOPUS, WEB OF SCIENCE, GOOGLE SCHOLAR, and SCIENCE DIRECT were searched independently by two authors for relevant articles from January 2011 to July 2021 using combinations of keywords. Primary studies published in English focusing on the behavioral and psychosocial risk factors for BQ chewing were included. RESULTS: Out of the initial 264 articles searched, 12 articles met the selection criteria. Included studies addressed the influence of behavioral and psychosocial factors toward the initiation and/or maintenance of BQ chewing. Included studies reported that dependent BQ was not able to quit BQ chewing due to habituation, addiction, and withdrawal symptoms. Few social BQ chewers in Southeast Asian countries were not willing to initiate quitting as they considered AN as an important social and cultural identifier and claimed that they could not resist chewing in a peer group, and it has become part of their social life. CONCLUSION: In the future, studies should take into consideration behavioral and psychosocial risk factors, which are major barriers toward successful quitting. These factors should be integrated into areca nut cessation guidelines, and there is a need to develop more comprehensive culture-specific intervention approaches to achieve long-term abstinence.

Congenital insensitivity to pain in a 1-year-old boy.

Congenital insensitivity to pain (CIP) is a rare autosomal recessive genetic condition which causes reduced pain sensation, thermal sensation, and habit of self-mutilation. It is a life-threatening condition where due to reduced pain sensation, patient might not understand the severity of the injury which can eventually lead to death. Such people live a compromised life and can also affect them psychologically. Here, we are reporting a case of an infant with clinical features suggestive of CIP with a mutation in exon 5 of PRDM12 gene. The child has minimal response to pain along with self-mutilation and mental retardation.

Morphometric evaluation of the frontal sinus in relation to age and gender in subjects residing in Davangere, Karnataka.

OBJECTIVE: The main objective of the study was morphometric evaluation of the frontal sinus in relation to age and gender and to establish its forensic importance and application. MATERIALS AND METHOD: The study group consisted of 200 subjects (100 males and 100 females) in the age groups 14-20 years, 21-30 years, 31-45 years, 45 years and above. Posteroanterior (PA) cephalogram radiographs were taken using standardized technique. The processed films were traced and frontal sinus pattern was established as per Yoshino's classification system. RESULTS: The mean values for length, width, and area of the frontal sinus were found to be higher in males as compared to females and area of frontal sinuses increase with age except in males who were 45 years and above. The left width, left area, and bilateral asymmetry in relation to gender was found to be statistically significant. CONCLUSION: The morphologic evaluation of frontal sinus is a useful technique to determine gender and seems promising in personal identification.

Ambras syndrome: A rare case report.

Congenital generalized hypertrichosis associated with gingival hyperplasia are rare cases published in literature. The frequency incidence of generalized congenital hypertrichosis is about one to billions of people. Hypertrichosis and gingival hyperplasia are termed as Ambras syndrome (AS), which can be noticed at birth or soon after. Here, is a rare case report of 4-year-old male child who presented with generalized hypertrichosis with gingival fibromatosis and dysmorphic facial features.

Aloe vera in dentistry.

Aloe vera is a medicinal plant which has been used for thousands of years. The health benefits of aloe vera is well known and the dental uses of this plant is multiple. Interest is gathering among researchers regarding the use of this plant. Studies have proved the antiseptic, anti inflammatory, antiviral and antifungal properties of aloe vera and the use of this plant is proved beneficial. This plant is proved to be non allergic and very good in building up the immune system. Aloe vera is gaining popularity in dentistry as it is completely natural and there is no side effects being reported with its use. This paper gives an overview of the uses of this miracle plant and its uses in dentistry.

Cavernous hemangioma of the tongue: A rare case report.

Hemangiomas are developmental vascular abnormalities and more than 50% of these lesions occur in the head and neck region, with the lips, tongue, buccal mucosa, and palate most commonly involved. They are considered as hamartomas rather than true neoplasms. Here we report a case of hemangioma of the body of the tongue, discussing the diagnostic aspects and treatment modalities of such lesion and emphasizing the role of the color Doppler ultrasonography, especially in the diagnosis and treatment. Factors such as patient's age, size and site of lesion and the proximity of lesion to vital structure are paramount in the determination of the therapeutic approach and surgical excision. Even though radiotherapy, cryotherapy, laser therapy, medical treatment, injection of sclerosing substances and the selective embolization of the lingual artery seem to have some efficacy, the author conclude that surgery is the therapy of choice in the isolated vascular lesions of the body of the tongue.

Idiopathic multiple impacted unerupted teeth: Case report and discussion.

Multiple impacted permanent teeth are usually related to syndromes, metabolic and hormonal disorders. However, in some cases, impaction of multiple teeth is not associated with any syndrome. In this report, we present a case of 17-year-old male patient with missing teeth. Radiographs revealed multiple impacted permanent teeth, though medical and family history along with physical examination was not suggestive of any syndromes. If other investigations are negative, an idiopathic case of multiple impacted teeth is suggested to be the possible diagnosis. The objective of this report is to increase awareness of such cases especially in the absence of hereditary/genetic/metabolic factors usually inherent in such scenarios. The patient management in such cases needs to be planned specifically from a multidisciplinary standpoint.

P2X7 receptor-pannexin 1 hemichannel association: effect of extracellular calcium on membrane permeabilization.

Activation of P2X(7) receptor (P2X(7)R) and pannexin have been implicated in membrane permeabilization associated with ischemic cell death and many other inflammatory processes. P2X(7)R has a unique property of forming large pore upon repeated or prolonged application of agonist like ATP or 2', 3'-(4-benzoyl) benzoyl ATP. It has been proposed that pannexin 1 (panx1) hemichannel associates with P2X(7)R to form large pore, though the actual mechanism is not yet understood. Calcium concentration in extracellular milieu drops in many patho-physiological conditions, e.g. ischemia, when P2X(7)R/pannexin is also known to be activated. Therefore, we hypothesize that extracellular calcium ([Ca(2+)](o)) plays an important role in the coupling of P2X(7)R-panx1 and subsequent membrane permeabilization. In this study we show that membrane permeability of the P2X(7)R and panx1 expressing N2A cell increases in ([Ca(2+)](o))-free solution. In [Ca(2+)](o)-free solution, fluorescent dye calcein trapped cells exhibited time-dependent dye leakage resulting in about 50% decrease of fluorescence intensity in 30 min. Control cells in 2 mM [Ca(2+)](o) did not show such leakage. Like N2A cells, mixed culture of neuron and glia, derived from hippocampal progenitor cells showed similar dye leakage. Dye leakage was blocked either by pannexin-specific blocker, carbenoxolone or P2X(7)R antagonists, Brilliant Blue G, and oxidized ATP. Furthermore P2X(7)R and panx1 were co-immunoprecipitated. The amount of P2X(7)R protein pulled-down with panx1, increased by twofold when cells were incubated 30 min in [Ca(2+)](o)-free buffer. Taken together, the results of this study demonstrate the activation and association of P2X(7)R-panx1, triggered by the removal of [Ca(2+)](o).

Oral bullous lichen planus: Case report and review of management.

A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus.

Pneumonitis following diesel fuel siphonage.

Petroleum diesel is a complex mixture of liquid hydrocarbons and mainly used as fuel in transport vehicles. The practice of manual siphoning of diesel from fuel tanks is common in developing countries but hydrocarbon pneumonitis due to diesel siphonage is rarely reported. We report pneumonitis following diesel fuel siphonage in a 30-year-old driver. Initially patient had severe nausea and vomiting followed by chest pain and breathlessness after three days. In our case, induced sputum was diagnostic as against majority of cases where bronchoscopy was used as diagnostic tool. Recovery was complete with medical treatment.

Cells behaviour in presence of nano-scaffolds.

Nanomaterials are being made for use in various fields in biology from sensors to clutches. Nanomaterials may be perceived, in bizarre ways by the cells. Starting from the membrane to the nucleus, each component of the cell could have a new response. Mesenchymal Stem Cells (MSC) isolated from human placenta, Wharton's jelly, cord blood, fetal bone marrow and adipose tissue, cultured in the presence of biomaterials were monitored for differentiation in to the osteogenic phenotype. On the basis of osteogenic marker expression analysis, placental cells exhibited the best osteogenic potential among the different MSC. There is some cell death initially but the cells that remain viable show uptake of nanoparticles. The viable cells both divide and show differentiation into osteogenic cell type. The placental MSC in conjunction with the biomaterials were implanted in the injured femur of Wistar rats showed complete regeneration of the damaged region.

Role of a dentist in discrimination of abuse from accident.

Most physical injuries resulting from abuse or violence are found on the head and neck areas that are clearly visible to the dental team during examination. Given that dental professionals routinely assess the head, face, and neck of patients, they are in a unique position to identify the signs of abuse and neglect. Involvement of a dentist in the protection team may be beneficial and can lead to early intervention. This article brings to light the importance of questioning and physical examination and the role of a dentist in identifying abuse, assault, and accident.

Estimation of salivary amylase and total proteins in leukemia patients and its correlation with clinical feature and radiographic finding.

BACKGROUND: Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. MATERIALS AND METHODS: In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. RESULTS: In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (P<.05). On intraoral examination the study subjects showed pallor, gingivitis, gingival enlargement, petechiae, and ecchymosis. On the OPG, the radiographic features included generalized rarefaction of bone (20%), thinning of lamina dura (3.4%), generalized alveolar crest bone resorption (30%), thinning of walls of alveolar crypts (6.7%), besides others, e.g., periapical abscess (10%). CONCLUSIONS: The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.

Evaluation of salivary cortisol and psychological factors in patients with oral lichen planus.

BACKGROUND AND OBJECTIVES: Lichen planus is a relatively common chronic inflammatory disease of oral mucosa and skin. Cortisol, also called as "stress hormone", has been used as an indicator in various stress evaluation studies. Salivary cortisol measurement is an indicator of free cortisol or biologically active cortisol in human serum and provides noninvasive and easy technique. Recent studies have been conflicting, and hence, in the present study, evaluation of salivary cortisol levels and psychosocial factors in oral lichen planus (OLP) patients was done. MATERIALS AND METHODS: A total of 30 patients with clinically and histopathologically proven cases of OLP, along with the age and sex-matched healthy controls were included in the study. Samples of stimulated saliva were collected, centrifuged and analyzed for the level of cortisol with cortisol enzyme linked immunosorbent assay. Psychosocial factors of study and control groups were measured by depression anxiety and stress scale. Student's t-test was used to compare the psychological factors and salivary cortisol levels between patients with the OLP and the control group. RESULTS: Irrespective of sex, significantly higher depression (83.4 +/- 15.4%), anxiety (80.5 +/- 11.3%), and stress (94.2 +/- 6.2%) scores were observed in OLP patients compared to controls. Increased cortisol levels were observed among 17 (56.6%) OLP patients in the study group. A positive correlation was found between psychological factors and salivary cortisol levels in the OLP patients. The values of Pearson's correlation coefficient "r", between depression, anxiety, and stress with salivary cortisol was: +0.42,S; +0.27,NS; and +0.65,HS, respectively among the study group.

Ellis-van Creveld syndrome: a case report.

Ellis-van Creveld syndrome (EvC) is a disease complex, where all the three embryonic layers appear to be involved. This disorder is also called as Chondroectodermal dysplasia. EvC is an autosomal recessive disorder resulting from mutations in these patients. Mutations in the two genes EVC and EVC2, have been identified to cause the condition. It has been considered as a skeletal dysplasia with an incidence of approximately 1 out of 1,50,000 live births. A high prevalence has been reported among certain populations like Amish and Arabs of Gaza strip. There are more than 300 cases of EvC reported into the literature. About 50-60% of cases have been reported with congenital cardiac malformations.

Dentigerous cyst associated with an ectopic third molar in the maxillary sinus: a rare entity.

Ectopic eruption of teeth into a region other than the oral cavity is rare although there have been reports of teeth in the nasal septum, mandibular condyle, coronoid process, palate, chin and maxillary sinus. Occasionally, a tooth may erupt in the maxillary sinus and present with local sinonasal symptoms attributed to chronic sinusitis. We present a case of an ectopic maxillary third molar tooth that caused chronic purulent sinusitis in relation to the right maxillary sinus.